Shoreline Healthcare Technologies is a proud Maine-based company that offers end to end revenue cycle management services to physicians and Medical billing companies  in Louisiana. Our goal is to help them manage their business in a way where they can focus on patient care and operations, not paperwork! By providing great services at reduced costs, we have been able to keep our customers since our inception in 2015.Explore our case studies to see how we’ve helped practices overcome complex billing challenges and improve cash flow.

As a medical billing outsourcing company, we have helped our clients grow their business by providing them with the resources they need to succeed while maintaining a competitive edge in today’s industry. We offer timesaving, cost-effective revenue cycle management services to your Louisiana-based practice. Ready to outsource your billing needs? We’ll guide you through your receivable account to make sure that your claims are paid.

Louisiana Billing Challenges we solve

Coordination with Hurricane-Related Emergency Policies

Louisiana frequently activates temporary Medicaid flexibilities during hurricanes, that might include suspended PA rules, alternative sites of care, backdated relaxations for claims. But once the emergency ends, rolling back these flexibilities causes confusion. Providers often get denials because they would have billed under emergency rules after the expiration date, MCOs reverted at different times, documentation expectations tightened without warning. Shoreline Healthcare Technologies keeps providers safe by monitoring LDH emergency announcements in real time, adjusting PA, place-of-service, and billing rules during emergency periods and rolling back the temporary billing flexibilities the moment LDH ends them. This ensures no bill is generated under the expired rules or lose reimbursement due to timing gaps.

Handling the Transitions Between Fee-For-Service & MCO Programs

Certain services like waiver programs, long-term care, dental, and specialized therapies keeps shifting back and forth between FFS and managed care oversight. And during these transitions claims hit outdated PA rules, providers might submit the claims to the wrong payer because mapping tables lag behind LDH announcements. This constant toggling creates unique gaps in coverage validation. A shoreline we avoid these confusions by monitoring the LDH transition bulletins and updating payer-of-record rules instantly, tagging claims for special handling during transition months (e.g., when PA rules change mid-quarter) and validate each claim against both systems before submission. This makes coverage transitions financially painless.

Bridging the Communication Gaps Between LDH and Healthy Louisiana MCOs

Louisiana’s Medicaid ecosystem still carries the older LDH platforms and workflows. When LDH updates coverage rules or PA criteria, the information does not always reach the Healthy Louisiana MCOs at the same pace. Providers often note that PA rules are updated by one plan before another, LDH bulletins taking more days or weeks to reflect in MCO provider manuals and claim editing logic differing drastically between plans despite the uniform state requirements. This mismatch forces practices to maintain separate rulesets for each plan, increasing administrative load and delaying reimbursement. We at Shoreline Healthcare Technologies maintain a seperate plan-by-plan rule trackers for all the Healthy Louisiana MCOs. Our billing teams receive weekly LDH bulletin digests, so updates propagate instantly into our claim’s workflow. Our denial management system flags pattern-based issues, meaning if one MCO suddenly changes editing logic, we detect it and adjust coding rules before more claims go out. This eliminates the silent errors that often drain revenue for months.

We at Shoreline Healthcare Technologies provide personalized support tailored to the unique needs of Louisiana providers. Our team of experts understands the intricacies of the Louisiana billing landscape and offers guidance to help practices navigate these challenges effectively with our cloud-based RCM solutions for an optimized Revenue Cycle Management.

Medical Billing Resources for Louisiana

Comprehensive resources specifically designed for Medicaid Providers to navigate the state’s complex Billing Landscape.

Medicaid Billing Guide

A Complete guide covering all billing requirements, policy updates and compliance standards.

Managed Care Organizations Billing rules and guidelines

Specialized billing guidelines and documentation procedures for MCOs.

Revenue Cycle Optimization

Best Practices and Strategies to improve cash flow and reduce denials.

Telehealth and Remote patient Monitoring in Louisiana

Louisiana’s telehealth and RPM guidelines and regulations.

Serving Healthcare Providers Across Louisiana

From Acadia to West Feliciana, we provide comprehensive medical billing services across all 64 Louisiana Parishes.

Greater New Orleans:

Jefferson, Orleans, Plaquemines, St. Bernard, St. Charles, St. John the Baptist, St. Tammany

Plantation Country:

Ascension, East Baton Rouge, East Feliciana, Iberville, Livingston, Pointe Coupee, St. Helena, St. James, Tangipahoa, Washington, West Baton Rouge, West Feliciana

Cajun Country:

Acadia, Assumption, Calcasieu, Cameron, Evangeline, Iberia, Jefferson Davis, Lafayette, Lafourche, St. Landry, St. Martin, St. Mary, Terrebonne, Vermilion

Crossroads:

Avoyelles, Catahoula, Concordia, Grant, La Salle, Natchitoches, Rapides, Sabine, Winn

Sportsman's Paradise:

Bienville, Bossier, Caddo, Caldwell, Claiborne, De Soto, East Carroll, Franklin, Jackson, Lincoln, Madison, Morehouse, Ouachita, Red River, Richland, Tensas, Union, Webster, West Carroll

Medical Billing Glossary

Essential Terms for Understanding the Louisiana’s Medical Billing Landscape

Healthy Louisiana

The Medicaid managed care program of the state of Louisiana that includes the major MCOs. Most of the Medicaid recipients are enrolled in Healthy Louisiana rather than the fee-for-service.

Health Standards Section (HSS)

The division responsible for licensing, surveying, and regulating healthcare facilities, home health agencies, behavioral health providers, and long-term care entities in Louisiana.

KIDMED

The Early and Periodic Screening, Diagnostic, and Treatment program in Louisiana which includes preventive health screenings for children under the age of 21.

Louisiana Health Insurance Premium Payment Program (LaHIPP)

A program where Louisiana Medicaid pays the health insurance premium for eligible Medicaid members who have access to employer-sponsored insurance. Providers must sometimes coordinate between commercial coverage and Medicaid for proper primary/secondary billing.

Medical Eligibility Verification System (MEVS)

The system used by providers in Louisiana to check a patient’s Medicaid eligibility. It provides the reports about the plan assignment, coverage span, TPL status, retroactive eligibility changes, and waiver program designations.

Recipient Eligibility Verification System (REVS)

The voice-response and web-based tool used to verify member eligibility for Louisiana Medicaid. While MEVS is more detailed, REVS provides quick real-time checks and is still widely used in rural areas and smaller practices.

Testimonials

My first time in solo practice I was very concerned about my ability to manage "the business side" of medicine. The personalized care and guidance this group provided to me and my staff were really a life saver. They always had quick turnaround on any questions I sent in, and were very knowledgeable for problem solving on the fly! I never feel like just a number, as I might have with a large corporation.

★ ★ ★ ★ ★

Family Medicine Centre in Maine

“We use Shoreline Medical Billing for all our billing needs, the support is second to none! They are always up to date with coding updates which helps to ensure timely billings and prompt payments. I highly recommend Shoreline Medical Billing for your billing needs.”

★ ★ ★ ★ ★

Nephrology Group in New Hampshire

I have been using Shoreline Medical Billing for almost 2 years, and I could not be more pleased with their service. They really care about my business. With all the complexities of medical billing, we needed a professional partner to help us. Shoreline delivered.

★ ★ ★ ★ ★

Pain Management in New Jersey

We switched to Shoreline Medical Billing. Our claims are getting paid, and we are getting friendly, knowledgeable service. We highly recommend Shoreline.

★ ★ ★ ★ ★

Internal Medicine & Nephrology in Georgia

I’m a small pediatric OT practice and have been with Shoreline for several years now. They have made it so easy for me to keep my focus on patient care by being so knowledgeable and so efficient with all aspects of my billing. When I do have questions, they are always available and able to help quickly. Couldn’t be happier!

★ ★ ★ ★ ★

Peds OT Clinic in Maine

Thanks so much for working so hard to help my company:) It sound cheesy, but having a biller I could trust changed my life by giving me the headspace/time to focus on clinical work, scale my business and sleep better at night. I've had quite a few people ask about you on Facebook Messenger from my posts. Overall, the feedback I've heard back from everyone is that you guys are very responsive and helpful.

★ ★ ★ ★ ★

Nurse Practitioner Group in Washington

Hi, following up on our conversation about Shoreline. I did let them know that I had some concerns and they were very understanding. They have been very responsive and proactive in their billing process, reports and communication. It has been very good. Thank for recommending them.

★ ★ ★ ★ ★

Nurse practitioner in Delaware

Before Shoreline, billing was a constant headache. Now, our reimbursements are faster, and I’m no longer chasing unpaid claims. Their team handles everything so efficiently, it’s one less thing I need to worry about.

★ ★ ★ ★ ★

🩺 Services	📍Louisiana Specialization	📈 Typical Improvement	⏱️ Turnaround Time
End-to-End Medical Billing	Custom workflows to meet the needs of Louisiana Medicaid and all major MCOs and FFS Medicaid Programs	20–35% reduction in denials, faster payment cycles across multiple plans.	Claim submission within 24–48 hours
Eligibility & Coverage Verification	Day-level verification to catch frequent Louisiana retroactive eligibility changes and mid-month MCO flips	15–30% drop in eligibility-based denials.	Same-day verification
Prior Authorization Management	Plan specific PA handling and routing	40–60% reduction in PA denials	3–5 business days for standard PAs
Denial Management	AI based tools to track and flag denial codes and root-cause analysis tailored for Medicaid claim categories, identifies high-risk categories and automate resubmissions.	Reduce rate of denial by 75% and with quicker appeals.	7–14 days for backlog cleanup; ongoing daily follow-up
Telehealth Billing	Applies telehealth geography rules, specific codes, modifiers, and POS	25–40% fewer telehealth denials	Same-day telehealth claim processing.
Patient Statements & Follow-Up	Communicate with patients and give Explanation of Benefits (EOBs). Includes text/email payment reminders and online payment options.	Reduces overdue balances and better collection rates.	1-2 weeks
Audit & Compliance Support	Conducts Audit Review and mock audits, including documentation, encounter verification, and claim reconciliation.	Minimizes risk of penalties and supports successful audits.	Ongoing, depending on audit schedule

Medicaid FFS Claims	365 days
Most MCOs	180-365 days depending on the plan
Appeals	90-180 days

The Reliable Medical Billing Company in Louisiana - Shoreline

Best In the Industry

Louisiana Billing Challenges we solve

Coordination with Hurricane-Related Emergency Policies

Handling the Transitions Between Fee-For-Service & MCO Programs

Bridging the Communication Gaps Between LDH and Healthy Louisiana MCOs

Comprehensive Medical Billing Services for Louisiana

Medical Billing Resources for Louisiana

Medicaid Billing Guide

Managed Care Organizations Billing rules and guidelines

Revenue Cycle Optimization

Telehealth and Remote patient Monitoring in Louisiana

Serving Healthcare Providers Across Louisiana

Greater New Orleans:

Plantation Country:

Cajun Country:

Crossroads:

Sportsman's Paradise:

Savings Estimation Calculator

Frequently Asked Questions

Q1. How do providers verify a patient’s eligibility for Louisiana Medicaid in real time?

Q2. How do we know whether a service requires PA under Louisiana Medicaid?

Q3. What is the timely filing limit for Louisiana Medicaid and its MCOs?

Q4. How does LaHIPP impact billing?

Q5. What happens to PA requirements during hurricanes or state emergencies?

Q6. How can Shoreline Healthcare Technologies help providers in Louisiana?

Compliance & Certifications

HIPAA Compliant

AAPC Certified

Louisiana Licensed

Medical Billing Glossary

Healthy Louisiana

Health Standards Section (HSS)

KIDMED

Louisiana Health Insurance Premium Payment Program (LaHIPP)

Medical Eligibility Verification System (MEVS)

Recipient Eligibility Verification System (REVS)

Our Services

Testimonials

Family Medicine Centre in Maine

Nephrology Group in New Hampshire

Pain Management in New Jersey

Internal Medicine & Nephrology in Georgia

Peds OT Clinic in Maine

Nurse Practitioner Group in Washington

Nurse practitioner in Delaware

Internal Medicine in Arizona

We Care

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